1 state of the state: hiv/std in texas ann robbins texas department of state health services june...
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State of the State:HIV/STD in Texas
Ann RobbinsTexas Department of State Health
ServicesJune 2009
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In 2007, there were 122,717 reported
diagnoses of sexually transmitted diseases.
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Chlamydia Cases, 2000-2008
0
20,000
40,000
60,000
80,000
100,000
120,000
2000 2001 2002 2003 2004 2005 2006 2007 2008
Year
Cas
es
Females, Age 15-24 Females, Other Ages Males, All Ages
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Chlamydia Case Rates by County 2007
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Gonorrhea Cases, 2000-2008
31,56931,76130,270
26,01624,33924,326
27,114
32,895
30,116
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
2000 2001 2002 2003 2004 2005 2006 2007 2008
Year
Cas
es
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Gonorrhea Case Rates by County 2007
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Primary and Secondary Syphilis Cases by Year of Report, 2000-2008
1,066
879
1,405
1,172
398
833
650591
479
0
200
400
600
800
1,000
1,200
1,400
1,600
2000 2001 2002 2003 2004 2005 2006 2007 2008
Year
Cas
es
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P&S Syphilis Case Rates by County -Texas, 2008
Rates 0.0 Cases/100,000
0.1 to 3.9 Cases/100,000
4.0 to 9.9 Cases/100,000
10 or More Cases/100,000
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PLWHA
Deaths
New Cases
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
2003 2004 2005 2006 2007
Year
Nu
mb
er:
PL
WH
A
0
1,000
2,000
3,000
4,000
5,000
6,000
Nu
mb
er:
New
Cas
es a
nd
D
eath
s
Persons Living with HIV/AIDS, New Diagnoses of HIV/AIDS, and Deaths among those with HIV/AIDS
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Texas Persons Living with HIV/AIDS (PLWHA) by County 2006
PLWHA 2006No cases
1-99
100-499
500-1,499
1,500-4,999
5,000-18,500
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Burden of STD in Texas disproportionately borne
by racial/ethic minorities.
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Chlamydia Case Rates by Year of Report and Race/Ethnicity - Texas, 2000-2008
0
200
400
600
800
1,000
1,200
2000 2001 2002 2003 2004 2005 2006 2007 2008
Year
Cas
es p
er 1
00,0
00
White Af. American Hispanic
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Gonorrhea Case Rates by Race/Ethnicity 2000-2008
0
100
200
300
400
500
600
700
800
2000 2001 2002 2003 2004 2005 2006 2007 2008
Year
Cas
es p
er 1
00,0
00
White Af. American Hispanic
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P&S Syphilis Case Rates by Year of Report and Race/Ethnicity - Texas,
2000-2008
0
5
10
15
20
25
30
35
2000 2001 2002 2003 2004 2005 2006 2007 2008
Year
Cas
es p
er 1
00,0
00
White Af. American Hispanic
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The rate of living HIV cases among Blacks in Texas is 3 to 4
times higher than the rate in Whites or Latinos.
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Number and Rate of PLWHA by Race/Ethnicity, 2003-2007
18,604 22,712
23,802
18,113
11,089
15,532
0
5,000
10,000
15,000
20,000
25,000
2003 2004 2005 2006 2007
White Black Hispanic
200.9165.9
713.7
891.1
177.0146.7
0
200
400
600
800
1,000
2003 2004 2005 2006 2007
White Black Hispanic
The number of black persons living with HIV/AIDS surpassed that of whites in 2005. The rate in 2007 was 4-5 times higher for blacks than for others.
Number Rate
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Rate of new HIV/AIDS diagnoses in Black women is 8 times higher than rate in
Latinas, 20 times higher than rate in White women.
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New Diagnoses, Number and Rate, by Sex and Race/Ethnicity, 2006
1,157
1,366
1,011
220
658
145
0
200
400
600
800
1,000
1,200
1,400
1,600
White Black Hispanic
Male Female
20.5
105.7
23.3
5.3
48.0
2.5
0
20
40
60
80
100
120
White Black Hispanic
Male Female
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• Over 5,000 newly acquired HIV infections in Texas in 2007– Blacks accounted for 39%– Latinos accounted for 30% – Whites/Others accounted for 31%
2007 Incidence Estimate
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One in…are Living with HIV/AIDS
One in 378 of all Texans
One in 498 of White Texans
One in 565 of Hispanic Texans
One in 112 of Black Texans
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In Texas, heterosexual transmissions account for
a growing number of newly diagnosed HIV
cases, but MSM still make up the majority of new HIV diagnoses and an increased number of syphilis diagnoses.
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P&S Syphilis Cases by Year of Report by Sex and MSM Risk, 2000-2008
0
200
400
600
800
1,000
1,200
1,400
1,600
2001 2002 2003 2004 2005 2006 2007 2008
Year
Cas
es
MSM P&S Male P&S Female P&S
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Mode of transmission in new and living cases of HIV in Texas, 2007
Newly Diagnosed
MSM52.5%
MSM/IDU3.9%
IDU13.0%
Het.29.8%
Other0.8%
Living Cases
MSM51.6%
MSM/IDU7.2%
IDU15.9%
Het.23.6%
Other1.6%
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1 in 3 Texans with HIV was diagnosed with AIDS within 1
year of first HIV + test
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% of Texans with HIV and AIDS Diagnoses within 1 Month and 1 Year
w/i 1 month
w/i 1 month
w/i 1 month
w/i 1 month
w/i 1 month
w/i 1 month
w/i 1 year
w/i 1 year
w/i 1 year
w/i 1 year
w/i 1 year
w/i 1 year
0.0 10.0 20.0 30.0 40.0 50.0
Hispanic
Black
White
Male
Female
Total
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BRFSS: HIV Testing Behavior
HIV Testing HistoryEver In Past Year
Hispanic 41% 15%
Black 64% 28%
White 41% 10%
Ever Tested for HIV among persons aged 18-64 years, Texas, 2007
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Estimated Percentages
Newly infected in 2007 and unaware of their status
Hispanic 64%
55%
58%
59%
Black
White/Other
Overall
Incidence Surveillance: 2007 Incidence Estimate
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Complexity
• Intersecting and Accelerating Epidemics– Psychiatric involvement
• Major depression• Substance use and abuse
• Need to address structural factors – Constrict or eliminate choices– Physically, socially, psychologically
separate and isolate
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Texas Hospital Discharge Data: Cost of HIV/AIDS and Hepatitis Admissions, 2005
HIV/AIDS
Principle Diagnosis CodeTotal
AdmissionsTotal
ChargesAverage Cost per Admission
AIDS 5153 $237,193,846 $46,030HIV 10 $85,295 $8,529
Total HIV/AIDS $237,279,141
Hepatitis
Principle Diagnosis CodeTotal
AdmissionsTotal
ChargesAverage Cost per Admission
Viral Hepatitic Delta 3 $134,833 $44,944Viral Hepatitis A 145 $2,368,533 $16,335Viral Hepatitis B 404 $9,270,562 $22,947Viral Hepatitis C 1185 $38,950,477 $32,870Viral Hepatitis E 5 $116,552 $23,310Viral Hepatitis Unspecified 159 $2,517,290 $15,832
Total Hepatitis $53,358,247